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Fazeli B, Masoudian M. SMOKING AND BUERGER’S DISEASE: FROM HYPOTHESES TO EVIDENCE SYNTHESIS. CENTRAL ASIAN JOURNAL OF MEDICAL HYPOTHESES AND ETHICS 2022. [DOI: 10.47316/cajmhe.2022.3.1.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Early after the definition of thromboangiitis obliterans (TAO), it was noticed that TAO patients are almost always tobacco smokers. Later on, the relationship between continued smoking and TAO prognosis was documented. Consequently, smoking came to be considered as the main cause of TAO. However, it is still unknown why, amongst millions of smokers, only a small number develop TAO. It also remains unknown why, of the TAO patients who continue smoking, only half of them show aggravation and undergo amputations. The aims of this review are to investigate evidence in support of or against the relationship between TAO and smoking, according to the TAO-related literature published from 1908 to January 2022, and to discover the possible role of smoking in TAO pathophysiology. Taken together, it appears that smoking predisposes TAO patients toward the potential harmful effects of the main aetiology and helps the main aetiology to develop vascular lesions. Therefore, smoking cessation would almost always be helpful for improving the prognosis of TAO patients and reducing disease manifestation. However, concluding that smoking is not the main aetiology of TAO would open a new door to finding the true main aetiology of TAO and to discovering the appropriate treatment and medical management of patients who fail to stop smoking.
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Digital Gangrene: An Unusual Manifestation of Non-Hodgkin Lymphoma. Case Rep Vasc Med 2022; 2022:8963753. [PMID: 35284148 PMCID: PMC8906966 DOI: 10.1155/2022/8963753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 02/07/2022] [Indexed: 12/02/2022] Open
Abstract
Background Non-Hodgkin lymphomas (NHLs) comprise a group of haematologic malignancies with different histologic subtypes. The clinical picture varies from indolent to aggressive presentation and nodal (lymphadenopathy) to extranodal (central nervous system, gastrointestinal, cutaneous plaque, or ulcer) involvement. Digital gangrene is seldom reported. Here, we describe a patient with pain and blackening of all fingers and toes as presenting symptoms of NHL. Case Presentation. A 32-year-old male weaver had been smoking three to five cannabis-containing cigarettes daily for about ten years and methamphetamine four to five tablets daily for five years. He had no history of Raynaud's phenomenon, fever, cough, weight loss, skin rash, joint pain, and atherogenic or thrombogenic risk factors. We found normal blood pressure and absent peripheral pulses in arms and legs, dry gangrene of all fingers and toes, generalized lymphadenopathy, and hepatomegaly with ascites. The chest X-ray was normal, as were blood sugar, lipid profile, and hepatic and renal function. Rheumatoid factor, antinuclear and antiphospholipid antibodies, C-ANCA and P-ANCA, hepatitis B and C, and HIV were negative. CT abdomen revealed hepatosplenomegaly with multiple intra-abdominal lymphadenopathies. The peripheral angiogram showed 90-99% stenosis of radial and dorsalis pedis arteries with normal proximal vessels. Diagnosis of non-Hodgkin lymphoma was confirmed by histopathology of cervical lymph node (diffuse type), immunohistochemically subtyped as peripheral T cell lymphoma (not otherwise specified). The digital ischemia worsened despite cessation of cannabis and methamphetamine and starting CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone) treatment, making amputation necessary. Conclusion We present, to our knowledge, the first report of peripheral T cell lymphoma, NOS presenting with gangrene in all digits complicated by methamphetamine and cannabis abuse. This uncommon vascular manifestation of non-Hodgkin lymphoma may cause a diagnostic dilemma and delayed initiation of treatment.
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The Management of Ischemic Limb in Thromboangiitis Obliterans (Buerger’s Disease). Indian J Surg 2021. [DOI: 10.1007/s12262-021-02748-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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CT-Guided Lumbar Sympathectomy as a Last Option for Chronic Limb-Threatening Ischemia of the Lower Limbs: Evaluation of Technical Factors and Long-Term Outcomes. AJR Am J Roentgenol 2021; 216:1273-1282. [PMID: 33655772 DOI: 10.2214/ajr.20.23089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE. The purpose of this study was to assess the effects of anatomic and technical factors on the long-term outcome of CT-guided lumbar sympathectomy in patients with chronic limb-threatening ischemia. SUBJECTS AND METHODS. Thirty patients (28 men, two women; mean age, 45.8 years) with chronic limb-threatening ischemia and diffuse tibial arterial disease not amenable to revascularization were included. CT-guided lumbar sympathectomy was performed at the L2-L3 level with a 22-gauge Chiba needle and absolute alcohol. Any periprocedural complication was noted. Numeric pain score (1-10 scale) and skin ulcers were assessed before the procedure and 3 weeks, 3 months, and 1 and 2 years after the procedure. According to spread of alcohol, patients were categorized into those with medial spread and those without medial spread (lateral spread group) with the lateral edge of the vertebral body as the reference point. Treatment results were categorized as improved, unchanged, or worsened on the basis of clinical response. RESULTS. There were 22 (73.3%) patients in the medial spread group and eight (26.7%) in the lateral spread group. The mean volumes of alcohol injected per side were not significantly different (p = .50). One major complication occurred in the group with medial spread. Mean numeric pain scores before the procedure and 3 weeks, 3 months, and 1 and 2 years afterward were 7.31, 2.95, 2.47, 2.10, and 2.04 in the medial spread group and 6.25, 4.13, 4.50, 4.35 and 4.32 in the lateral spread group (p < .001). At 2 years, 16 patients in the medial spread group and two patients in the lateral spread group showed clinical improvement (p < .001), and the limb salvage rates were 100% and 87.5%, respectively. Multivariate analysis showed a trend in improvement with smoking cessation, but the difference was not statistically significant (p = .15). The direction of spread of the neurolytic agent, however, was a major determinant of outcome. CONCLUSION. CT-guided lumbar sympathectomy is a simple, safe, and effective procedure. Ensuring medial spread of the neurolytic agent significantly improves long-term results.
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Choi B, Jang SY, Kim SK, Kim N, Kim K, Kim DK. The incidence, prevalence, and survival rate of thromboangiitis obliterans in Korea: a retrospective population-based study. Cardiovasc Diagn Ther 2020; 10:1238-1244. [PMID: 33224747 DOI: 10.21037/cdt-20-582] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Few studies used nationwide data to assess the age-standardized prevalence rate, incidence rate, 10-year survival rate, and death risk of thromboangiitis obliterans (TAO; Buerger's disease). Methods Data for 24,392 patients who had newly diagnoses related to TAO (I73.1) from 2006 through 2017 were extracted from the National Health Insurance Service in Korea. The age-standardized prevalence rate, incidence rate, 10-year survival rate, and death risk of TAO were analyzed. Results The mean (standard deviation) age of TAO patients overall was 62.0 (15.7) years; 61.3 (15.4) in males and 63.2 (16.1) in females (P<0.001). The proportion of patients older than 50 years old was about 80% overall. The proportion patients who died of TAO was 28.1%. Overall, the age-standardized prevalence rate of TAO decreased from 11.1 persons per 100,000 persons in 2006 to 8.43 persons in 2017, and overall, the incidence rate of TAO decreased from 6.07 persons in 2006 to 3.38 persons in 2017. The age-standardized prevalence rate and incidence rate in males were higher than that in females. The 10-year survival rate of TAO was about 65% (60.7% in males and 72.5% in females). The adjusted hazard ratio increased significantly with older age, male sex, hypertension, diabetes mellitus, myocardial infarction, heart failure, ischemic stroke, hemorrhagic stroke, chronic kidney disease, and malignant neoplasm. Conclusions The 10-year survival rate of TAO was about 65%. Even though the age-standardized prevalence rate and incidence rate of TAO is decreased during the study period, the adjusted hazard ratio showed significantly increases with age and with male sex after adjustment for comorbidities.
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Affiliation(s)
- Bareun Choi
- Department of Physical Medicine and Rehabilitation, Korea University Anam Hospital, 73 Goryeodae-ro Seongbuk-gu, Seoul, Republic of Korea
| | - Shin Yi Jang
- Imaging Center, Heart Vascular Stroke Institute, Samsung Medical Center, 81 Irwon-ro, Kangnam-gu, Seoul, Republic of Korea
| | - Seong-Kyong Kim
- Departmentof Orthopedic Surgery, Samsung Medical Center, 81 Irwon-ro, Kangnam-gu, Seoul, Republic of Korea
| | - Nari Kim
- Department of Nursing, Samsung Medical Center, 81 Irwon-ro, Kangnam-gu, Seoul, Republic of Korea
| | - Kyeongsug Kim
- Department of Nursing, Samsung Medical Center, 81 Irwon-ro, Kangnam-gu, Seoul, Republic of Korea
| | - Dong Kyu Kim
- Department of Rehabilitation Medicine, Konkuk University Chungju Hospital, Konkuk University School of Medicine, 82 Gugwon-daero, Chungju, Republic of Korea
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Kim J, Rana S, Lee W, Haque SE, Yoon JH. How the Bidi Tobacco Industry Harms Child-workers: Results From a Walk-through and Quantitative Survey. Saf Health Work 2020; 11:143-151. [PMID: 32596008 PMCID: PMC7303532 DOI: 10.1016/j.shaw.2020.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 02/14/2020] [Accepted: 02/25/2020] [Indexed: 11/26/2022] Open
Abstract
Objective Bidi is an inexpensive, low-processed, hand-rolled tobacco product. In Bangladesh, especially in Rangpur, tobacco farming and bidi processing are common. In this study, we aimed to evaluate the impact of bidi making on children working in bidi factories. Methods This qualitative(walk-through survey) and quantitative(questionnaire-based survey and a urine cotinine level quantitation) study was conducted in Rangpur, Bangladesh in 2017. Study population included child-workers aged ≤14 years who were regularly employed as bidi makers. Findings The results of the walk-through survey revealed hazardous working environments at bidi factories. For the quantitative survey, 171 child-workers were categorized into "less-working"(<5 hours/day) and "more-working"(≥5 hours/day) groups; additionally, "forced-working"(forced into work by parents) and "voluntary-working"(working voluntarily) groups were delineated within the same population. In the logistic regression analysis, odds ratios(ORs) of respiratory symptoms and unusual absence(absent ≥5 days/month) were higher in the "more-working" group than in the "less-working" group(unusual absence: OR, 2.91; 95% confidence interval[CI], 1.43-5.94), and this association became higher in the "forced-working" group with longer working hours(OR, 5.68, 95%CI 2.30-14.00). Conclusions Cheap, hand-rolled tobacco(bidi) is harmful to the health of bidi-making child-workers. Children in poverty bow to the demands of cheap labor and poverty and jeopardize their health and future prospects by working in bidi factories. Tobacco control policies should consider the social effects of tobacco beyond its biological effects.
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Affiliation(s)
- Jihyun Kim
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sohel Rana
- Bridge of Community Development Foundation, Dhaka, Bangladesh
| | - Wanhyung Lee
- Department of Occupational and Environmental Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | | | - Jin-Ha Yoon
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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Cacione DG, do Carmo Novaes F, Moreno DH. Stem cell therapy for treatment of thromboangiitis obliterans (Buerger's disease). Cochrane Database Syst Rev 2018; 10:CD012794. [PMID: 30378681 PMCID: PMC6516882 DOI: 10.1002/14651858.cd012794.pub2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Thromboangiitis obliterans, also known as Buerger's disease, is a non-atherosclerotic, segmental inflammatory pathology that most commonly affects the small- and medium-sized arteries, veins, and nerves in the upper and lower extremities. The etiology is unknown, but involves hereditary susceptibility, tobacco exposure, immune and coagulation responses. In many cases, there is no possibility of revascularization to improve the condition. Stem cell therapy is an option for patients with severe complications, such as ischemic ulcers or rest pain. OBJECTIVES To assess the effectiveness and safety of stem cell therapy in individuals with thromboangiitis obliterans (Buerger's disease). SEARCH METHODS The Cochrane Vascular Information Specialist searched the Cochrane Vascular Specialised Register, CENTRAL, MEDLINE, Embase, CINAHL and AMED databases and World Health Organization International Clinical Trials Registry Platform and ClinicalTrials.gov trials registers to 17 October 2017. The review authors searched the European grey literature OpenGrey Database, screened reference lists of relevant studies and contacted study authors. SELECTION CRITERIA Randomized controlled trials (RCTs) or quasi-RCTs of stem cell therapy in thromboangiitis obliterans (Buerger's disease). DATA COLLECTION AND ANALYSIS The review authors (DC, DM, FN) independently assessed the studies, extracted data and performed data analysis. MAIN RESULTS We only included one RCT (18 participants with thromboangiitis obliterans) comparing the implantation of stem cell derived from bone marrow with placebo and standard wound dressing care in this review. We identified no studies that compared stem cell therapy (bone marrow source) versus stem cell therapy (umbilical cord source), stem cell therapy (any source) versus pharmacological treatment and stem cell therapy (any source) versus sympathectomy. Ulcer healing was assessed in the form of ulcer size. The mean ulcer area decreased more in the stem cell implantation group: from 5.04 cm2 (standard deviation (SD) 0.70) to 1.48 cm2 (SD 0.56) compared with the control group: mean ulcer size area decreased from 4.68 cm2 (SD 0.62) to 3.59 cm2 (SD 0.14); mean difference (MD) -2.11 cm2, 95% confidence interval (CI) -2.49 to -1.73; 1 study, 18 participants; very low-quality evidence. Pain-free walking distance showed more of an improvement in the stem cell implantation group: from mean of 38.33 meters (SD 17.68) to 284.44 meters (SD 212.12) compared with the control group: mean walking distance increased from 35.66 meters (SD 19.79) to 78.22 meters (SD 35.35); MD 206.22 meters, 95% CI 65.73 to 346.71; 1 study; 18 participants; very low-quality evidence.Outcomes such as rate of amputation, pain, amputation-free survival and adverse effects were not assessed.The quality of evidence was classified as very low, with only one study, small numbers of participants, high risk of bias in many domains and missing information regarding tobacco exposure status. AUTHORS' CONCLUSIONS Very low-quality evidence suggests there may be an effect of the use of bone marrow-derived stem cells in the healing of ulcers and improvement in the pain-free walking distance in patients with Buerger's disease. High-quality trials assessing the effectiveness of stem cell therapy for treatment of patients with thromboangiitis obliterans (Buerger's disease) are needed.
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Affiliation(s)
- Daniel G Cacione
- UNIFESP – Escola Paulista de MedicinaDivision of Vascular and Endovascular Surgery, Department of SurgeryRua Borges Lagoa, 564 cj 124Vila ClementinoSão PauloBrazil04038000
| | | | - Daniel H Moreno
- UNIFESP – Escola Paulista de MedicinaDivision of Vascular and Endovascular Surgery, Department of SurgeryRua Borges Lagoa, 564 cj 124Vila ClementinoSão PauloBrazil04038000
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Cacione DG, Moreno DH. Stem cell therapy for treatment of thromboangiitis obliterans (Buerger's disease). Hippokratia 2017. [DOI: 10.1002/14651858.cd012794] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Daniel G Cacione
- UNIFESP - Escola Paulista de Medicina; Division of Vascular and Endovascular Surgery, Department of Surgery; Rua Borges Lagoa, 564 cj 124 Vila Clementino São Paulo Brazil 04038000
| | - Daniel H Moreno
- UNIFESP - Escola Paulista de Medicina; Division of Vascular and Endovascular Surgery, Department of Surgery; Rua Borges Lagoa, 564 cj 124 Vila Clementino São Paulo Brazil 04038000
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Efficacy of Endovascular Radiofrequency Ablation for Thromboangiitis Obliterans (Buerger's Disease). Ann Vasc Surg 2017; 42:78-83. [DOI: 10.1016/j.avsg.2016.11.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 10/31/2016] [Accepted: 11/09/2016] [Indexed: 01/04/2023]
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Modaghegh MHS, Kazemzadeh GH, Ravari H, Johari HG, Barzanuni A. Buerger’s disease in the northeast of Iran: Epidemiology and clinical features. Vascular 2014; 23:519-24. [DOI: 10.1177/1708538114552838] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background The aim of this study is to present our long-term clinical experience in describing a clinical picture of Buerger's disease in our region. Materials and methods In a retrospective study, files of 225 patients who were admitted to the hospital with diagnosis of thromboangiitis obliterans in a 10 year period from 2000 to 2010 were reviewed. All data including demographic, signs and symptoms, history of previous illness, history of smoking, medications, laboratory tests, angiography, and details of surgical operation were obtained. Results A total of 222 (98.7%) and 3 (1.3%) of patients were male and female, respectively. Average age of hospitalized patients was 40.7 ± 8.5 (20–62) years. A total of 200 patients (88.9%) were active cigarette smokers while 168 (74.7%) of them were opium addicts. The most prevalent symptoms were chronic ulcers (80%) and claudication (63.6%). Minor and major amputation was required in 113 (50.2%) and 41 (18.4%) patients, respectively. Amputation was carried out on the lower limb (80%), upper limb (4.1%), or on both (15.1%). Also, four patients underwent revascularization through surgical bypass procedures. Conclusions The diagnosis and treatment of Buerger’s Disease is still a challenge in those communities where the disease is endemic. Therefore, identifying the natural course of the disease can play a pivotal role in the diagnosis and treatment of these patients.
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Affiliation(s)
| | - Gholam Hosein Kazemzadeh
- Vascular and Endovascular Surgery Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Iran
| | - Hassan Ravari
- Vascular and Endovascular Surgery Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Iran
| | - Hamed Ghoddusi Johari
- Trauma Research Center, General Surgery Department, Shiraz University of Medical Sciences, Iran
| | - Amir Barzanuni
- Vascular and Endovascular Surgery Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Iran
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Abstract
Thromboangiitis obliterans (TAO) is nonatherosclerotic inflammatory disease of the peripheral blood vessels, and TAO affects the small and medium sized vessels of the extremities. TAO is mainly seen in young males who smoke, and smoking is strongly associated with the disease course and progression. The diagnosis is made on the basis of the history, the physical examination and the clinical diagnostic criteria. As the bedrock for treating patients with TAO, absolute abstinence from tobacco is most important factor, and patients with TAO are usually managed conservatively. Surgical bypass or endovascular therapy is usually not possible for patients with TAO because of the diffuse segmental involvement and the distal nature of the disease. Therefore, stem cell therapy is considered to be a novel therapeutic modality for treating patients with TAO and who are not eligible for conventional revascularization therapies. In this paper, I have summarized the recent knowledge about TAO and I have reviewed the recent studies that have focused on the treatment of TAO.
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Affiliation(s)
- Ui-Jun Park
- Division of Vascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong-Ik Kim
- Division of Vascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Hanifi SMA, Mahmood SS, Bhuiya A. Smoking has declined but not for all: findings from a study in a rural area of Bangladesh. Asia Pac J Public Health 2010; 23:662-71. [PMID: 20498124 DOI: 10.1177/1010539509351051] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
UNLABELLED Smoking is one of the leading causes of death and two-thirds of the world's smokers live in 10 countries, including Bangladesh. This study examines the trend and differentials in smoking in Chakaria, Bangladesh. Data from 2 surveys conducted in 1994 and 2008 in Chakaria were used. RESULTS showed that smoking declined from 41% in 1994 to 27% in 2008. However, the decline was lower among the poor and the rate remained the same for the female illiterate. Interventions to prevent smoking need to be designed such that they are effective in disadvantaged groups and do not contribute to widening of socioeconomic inequalities in smoking prevalence and tobacco-related ill health and death.
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Affiliation(s)
- S M A Hanifi
- Social and Behavioural Sciences Unit, Public Health Sciences Division, Dhaka, Bangladesh.
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Miot HA, Miot LDB, Lopes PS, Haddad GR, Marques SA. Association between palmoplantar pustulosis and cigarette smoking in Brazil: a case-control study. J Eur Acad Dermatol Venereol 2009; 23:1173-7. [PMID: 19453779 DOI: 10.1111/j.1468-3083.2009.03282.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Palmoplantar pustulosis (PPP) discloses some differences compared to vulgar psoriasis (PV) in terms of age of onset, female predominance and low occurrence of psoriasis lesions elsewhere. Cigarette smoking has been associated to PPP in international studies; nevertheless, these studies were never performed among Brazilian. OBJECTIVES To compare prevalence of smoking among PPP, PV and other dermatologic patients (NPD). METHODS Case-control study involving 25 PPP patients from a reference psoriasis centre. Two control groups were matched according to gender and age: 50 patients with PV and 50 NPD. Confounders were adjusted by conditional multiple logistic regression. RESULTS Among cases, 84.0% were female and PPP age of disease onset (41.4 years) was greater than PV (34.5 years). Prevalence of ever smoking was higher among cases (92.0%) than PV (52.0%) and NPD (30.0%). Adjusted odds ratio of PPP ever smoking compared to PV and NPD was 9.5 and 36.2, respectively. All smokers reported the onset of their habit before the development of PPP. CONCLUSIONS There was significant association between PPP and smoking. However, the impact of giving it up in the clinical course of the disease remains to be established.
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Affiliation(s)
- H A Miot
- Departamento de Dermatologia e Radioterapia da Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (FMB-Unesp), Botucatu, Brazil.
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Khan MMH, Khan A, Kraemer A, Mori M. Prevalence and correlates of smoking among urban adult men in Bangladesh: slum versus non-slum comparison. BMC Public Health 2009; 9:149. [PMID: 19463157 PMCID: PMC2705350 DOI: 10.1186/1471-2458-9-149] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2008] [Accepted: 05/22/2009] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Smoking is one of the leading causes of premature death particularly in developing countries. The prevalence of smoking is high among the general male population in Bangladesh. Unfortunately smoking information including correlates of smoking in the cities especially in the urban slums is very scarce, although urbanization is rapid in Bangladesh and slums are growing quickly in its major cities. Therefore this study reported prevalences of cigarette and bidi smoking and their correlates separately by urban slums and non-slums in Bangladesh. METHODS We used secondary data which was collected by the 2006 Urban Health Survey. The data were representative for the urban areas in Bangladesh. Both slums and non-slums located in the six City Corporations were considered. Slums in the cities were identified by two steps, first by using the satellite images and secondly by ground truthing. At the next stage, several clusters of households were selected by using proportional sampling. Then from each of the selected clusters, about 25 households were randomly selected. Information of a total of 12,155 adult men, aged 15-59 years, was analyzed by stratifying them into slum (= 6,488) and non-slum (= 5,667) groups. Simple frequency, bivariable and multivariable logistic regression analyses were performed using SPSS. RESULTS Overall smoking prevalence for the total sample was 53.6% with significantly higher prevalences among men in slums (59.8%) than non-slums (46.4%). Respondents living in slums reported a significantly (P < 0.001) higher prevalence of smoking cigarettes (53.3%) as compared to those living in non-slums (44.6%). A similar pattern was found for bidis (slums = 11.4% and non-slums = 3.2%, P < 0.001). Multivariable logistic regression revealed significantly higher odds ratio (OR) of smoking cigarettes (OR = 1.12, 95% CI = 1.03-1.22), bidis (OR = 1.90, 95% CI = 1.58-2.29) and any of the two (OR = 1.23, 95% CI = 1.13-1.34) among men living in slums as compared to those living in non-slums when controlled for age, division, education, marital status, religion, birth place and types of work. Division, education and types of work were the common significant correlates for both cigarette and bidi smoking in slums and non-slums by multivariable logistic regressions. Other significant correlates of smoking cigarettes were marital status (both areas), birth place (slums), and religion (non-slums). Similarly significant factors for smoking bidis were age (both areas), marital status (slums), religion (non-slums), and birth place (both areas). CONCLUSION The men living in the urban slums reported higher rates of smoking cigarettes and bidis as compared to men living in the urban non-slums. Some of the significant correlates of smoking e.g. education and division should be considered for prevention activities. Our findings clearly underscore the necessity of interventions and preventions by policy makers, public health experts and other stakeholders in slums because smoking was more prevalent in the slum communities with detrimental health sequelae.
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Affiliation(s)
- Md Mobarak Hossain Khan
- Department of Public Health Medicine, School of Public Health, Bielefeld University, Germany
| | - Aklimunnessa Khan
- Department of Public Health, Sapporo Medical University School of Medicine, Japan
| | - Alexander Kraemer
- Department of Public Health Medicine, School of Public Health, Bielefeld University, Germany
| | - Mitsuru Mori
- Department of Public Health, Sapporo Medical University School of Medicine, Japan
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Małecki R, Zdrojowy K, Adamiec R. Thromboangiitis obliterans in the 21st century--a new face of disease. Atherosclerosis 2009; 206:328-34. [PMID: 19269635 DOI: 10.1016/j.atherosclerosis.2009.01.042] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2008] [Revised: 01/14/2009] [Accepted: 01/30/2009] [Indexed: 10/21/2022]
Abstract
Thromboangiitis obliterans (TAO) is a relatively rare disease of peripheral blood vessels, affecting small and medium sized arteries and veins. Although the first description of the disease was given by Winiwarter almost 130 years ago, etiology of TAO remains not elucidated. Smoking is considered as a precipitating factor of the disease. We emphasised some particular features of the new face of TAO - significant decrease in incidences, increased disease prevalence among women and coexistence of other than smoking atherosclerotic risk factors (especially disturbances of glucose metabolism). Contemporary methods of treatment were also discussed.
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Affiliation(s)
- Rafał Małecki
- Department of Angiology, Arterial Hypertension and Diabetology, Wrocław Medical University, Lower Silesia, Poland.
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Noël B, Ruf I, Panizzon RG. Cannabis arteritis. J Am Acad Dermatol 2008; 58:S65-7. [DOI: 10.1016/j.jaad.2007.04.024] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2007] [Revised: 04/11/2007] [Accepted: 04/19/2007] [Indexed: 10/22/2022]
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Yavas US, Calisir C, Kaya T. Vasculogenic impotence as a symptom in late-onset Buerger's disease. JOURNAL OF CLINICAL ULTRASOUND : JCU 2007; 35:469-72. [PMID: 17486572 DOI: 10.1002/jcu.20356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Buerger's disease, or thromboangiitis obliterans, is a nonatherosclerotic, noninflammatory, segmentally occlusive disease of unclear etiology. We report a case of late-onset Buerger's disease in a 57-year-old man with erectile dysfunction, an uncommon symptom that occurred shortly after intermittent claudication.
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Affiliation(s)
- Ulas Savas Yavas
- Department of Radiology, Osmangazi University, Medical Faculty, Eskisehir 26000, Turkey
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Arsenic in drinking water and bladder cancer: review of epidemiological evidence. ACTA ACUST UNITED AC 2007. [DOI: 10.1016/s1875-1121(06)09021-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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Khan MMH, Aklimunnessa K, Kabir MA, Kabir M, Mori M. Tobacco consumption and its association with illicit drug use among men in Bangladesh. Addiction 2006; 101:1178-86. [PMID: 16869847 DOI: 10.1111/j.1360-0443.2006.01514.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
AIMS This study examined the association of tobacco consumption (smoking and chewing) with illicit drug use among Bangladesh males. DESIGN Cross-sectional survey data from the Bangladesh Demographic and Health Survey 2004 were used. SETTING Bangladesh. PARTICIPANTS A total of 4297 males aged 15-54 years. MEASUREMENTS Age, education, religion, marital status, place of residence; tobacco consumption such as cigarette and bidi smoking, chewing sada, pata, tobacco leaves, gul, betel quid with zarda; taking illicit drugs such as ganja, charas, heroin, pethedine, phensidyl; having sexually transmitted diseases (STDs). FINDINGS Overall prevalence of tobacco consumption was 59%. Bidi smoking (29.6%), cigarette smoking (27.8%) and chewing betel quid with tobacco/zarda (17.5%) were predominant. Overall prevalence of illicit drug use was 4%. Ganja was the main drug (3%), followed by phensidyl (0.8%), heroin (0.3%) and charas (0.3%). Age, education, place of residence, marital status, having STDs, premarital and extra-marital sex were associated significantly with tobacco smoking. Almost all variables were also associated significantly with illicit drug use. Smoking cigarettes and bidi and eating tobacco leaves/shada pata/gul showed significantly positive associations with illicit drug use when adjusted for other variables. CONCLUSIONS Tobacco consumption is common and associated positively with the illicit drug use among males in Bangladesh.
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Affiliation(s)
- M M H Khan
- Department of Public Health, Sapporo Medical University School of Medicine, Japan.
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Kröger K. Buerger's disease: What has the last decade taught us? Eur J Intern Med 2006; 17:227-34. [PMID: 16762770 DOI: 10.1016/j.ejim.2005.11.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2005] [Revised: 11/14/2005] [Accepted: 11/24/2005] [Indexed: 10/24/2022]
Abstract
Thrombangiitis obliterans (TAO), or Buerger's disease, is most likely an endarteritis that is introduced by T-cell-mediated cellular immunity and B-cell-mediated humoral immunity associated with the activation of macrophages or dendritic cells in the intima. There is no specific marker of the disease, and the diagnosis is based on clinical and angiographic criteria. The disease spontaneously leads to tissue loss and major amputations and is self-limiting in the 5th to 6th decades of life. Patients should quit smoking and be offered treatment with prostaglandin or prostacyclin, modern wound management, and pain-relieving drugs. Surgical revascularization may be indicated in elective patients, and amputation should only be the last option. It has been suggested that environmental factors may play a major role in the modification of the disease process. TAO is a typical lower class disease, the social and psychological components of which are widely unexplored. Unfortunately, the last decade has not taught us anything to enable us to improve the treatment of TAO patients.
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Affiliation(s)
- K Kröger
- Department of Angiology, University Hospital Essen, Germany
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Abstract
Thromboangiitis obliterans is a vascular disease characterized by a segmental, non-atherosclerotic inflammation of the small and medium-sized arteries and veins. The vascular changes are mainly found on the distal extremities. Involvement of visceral organs is rare. Affected patients are mostly young male smokers, who develop ulcers and gangrene of the toes and fingers as a result of the vascular ischaemia. Diagnosis is made using characteristic clinical criteria as well as pathological findings in arteriography and histopathology. Although the exact underlying causes of Buerger's disease are still unknown, the disease is strongly associated with tobacco smoking. Although most investigators speculate about an autoimmune mechanism, no causative antigens have yet been discovered. The only definite form of therapy is the discontinuation of tobacco use. On the basis of smoking cessation, further therapies (e.g. administration of prostacyclin analoga) are possible. The mortality rate for patients with Buerger's disease is not higher than that for the rest of the adult population, but patients often require minor and major limb amputation due to ulcerations.
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Affiliation(s)
- Daniela Hoeft
- Dermatologische Klinik und Poliklinik, Universitätsklinikum Essen
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Miot HA, Bartoli Miot LD, Haddad GR. Association between Discoid Lupus erythematosus and Cigarette Smoking. Dermatology 2005; 211:118-22. [PMID: 16088157 DOI: 10.1159/000086440] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2004] [Accepted: 12/20/2004] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Discoid lupus erythematosus (DLE) is a chronic cutaneous disease affecting photoexposed areas and has also been associated with cigarette smoking. OBJECTIVE To evaluate the association between smoking and DLE. METHODS A case-control study was performed involving 57 cases diagnosed with DLE and 215 healthy controls. RESULTS A higher smoking prevalence was noted in DLE cases (84.2%) than controls (33.5%), and the odds ratio adjusted for gender, age and ultraviolet index in the city of origin was 14.4 (95% confidence interval 6.2-33.8; multiple logistic regression, p < 0.01). The cumulative smoking exposure was not related to premature DLE development. At the beginning of the disease, smokers had more extensive involvement than nonsmokers; compromise of the upper arms was statistically related to smoking. CONCLUSION Cigarette smoking was statistically associated with DLE development. Other studies are needed in order to evaluate the effects of smoking cessation on the course of disease.
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Soldz S, Dorsey E. Youth attitudes and beliefs toward alternative tobacco products: cigars, bidis, and kreteks. HEALTH EDUCATION & BEHAVIOR 2005; 32:549-66. [PMID: 16009750 DOI: 10.1177/1090198105276219] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Youth use of cigars, bidis, and kreteks has spread as youth cigarette use has declined. This study investigates young people's attitudes toward and beliefs about these alternative tobacco products. The study used data from a convenience sample survey of 5,016 7th-through 12th-grade students in Massachusetts. The cigar attitudes receiving the highest endorsement levels were that cigars smell good and are something different to try, whereas the item receiving the lowest endorsement was that cigars give you a goodbuzz. The most endorsed bidi attitudes were that bid is look like joints and are something different to try. For kreteks, the most endorsed items were that kreteks smell good and are something different to try. Multivariate analyses found that reporting that these products tasted, smelled good, or were something different to try predicted use. Because the study was conducted with a convenience sample in one state, results do not necessarily generalize.
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Affiliation(s)
- Stephen Soldz
- Boston Graduate School of Psychoanalysis, Brookline, Massachusetts 02446, USA.
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Pouye A, Ka MM, N'dongo S, Diallo S, Fall S, Diop SB, Coume M, Leye A, Diop-Moreira T. [Possible confusion between Buerger disease and Hansen disease in tropical area: report of a case]. Rev Med Interne 2004; 25:606-7. [PMID: 15276296 DOI: 10.1016/j.revmed.2004.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2004] [Accepted: 04/01/2004] [Indexed: 11/19/2022]
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Abstract
Several epidemiological studies suggest that bidi smoking increases the risk of oral cancer. No systematic review, however, has been reported to examine how consistent the evidence is across the studies. We undertook a meta-analysis of epidemiological studies investigating the relationship between bidi smoking and oral cancer. Primary studies were identified through a computerized literature search of Medline. Articles abstracted were all epidemiological studies published as original articles in English during 1966-2002 that included quantitative information on bidi smoking and oral cancer. Summary odds ratios (OR) were calculated based on random effects model. A total of 12 case-control studies used for this meta-analysis provided the summary estimates of OR of bidi smoking for oral cancer compared to that of non-smokers. An increased risk of oral cancer was found for bidi smokers compared to never smokers (OR = 3.1, 95% confidence interval [CI] 2.0-5.0) whereas no significant pattern of risk was found for cigarette smokers (OR = 1.1, 95% CI = 0.7-1.8). There was substantial heterogeneity in the pooled OR estimate. Our results clearly indicate that bidi smokers are at increased risk of oral cancer. It is important that this information be incorporated into smoking prevention and cessation efforts, particularly among the urban poor and rural mass in South Asian countries where bidi smoking is widely prevalent.
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Affiliation(s)
- Mahbubur Rahman
- Department of Epidemiological and Clinical Research Information Management, Kyoto University Graduate School of Medicine, Yoshidakonoe-cho, Sakyo-ku, Kyoto, Japan
| | - Junichi Sakamoto
- Department of Epidemiological and Clinical Research Information Management, Kyoto University Graduate School of Medicine, Yoshidakonoe-cho, Sakyo-ku, Kyoto, Japan
| | - Tsuguya Fukui
- Department of General Medicine and Clinical Epidemiology, Kyoto University Graduate School of Medicine, Shogoin, Sakyo-ku, Kyoto, Japan
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Soldz S, Huyser DJ, Dorsey E. Characteristics of users of cigars, bidis, and kreteks and the relationship to cigarette use. Prev Med 2003; 37:250-8. [PMID: 12914831 DOI: 10.1016/s0091-7435(03)00121-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND In the 1990s, youth use of alternative tobacco products including cigars, bidis, and kreteks increased. This article discusses the prevalence of youth use of cigars, bidis, and kreteks, and characteristics of users. METHODS The Cigar Use Reasons Evaluation (CURE)-a questionnaire assessing alternative tobacco use and associated attitudes and behaviors-was administered to middle and high school students from 12 school districts across Massachusetts. RESULTS Males were more likely to use all forms of alternative tobacco and females more likely to smoke cigarettes. Hispanics were less likely to smoke kreteks or use smokeless tobacco. Urban students were more likely to smoke bidis or use smokeless tobacco than suburban or rural youth. Most smokeless and alternative tobacco users were lifetime cigarette smokers. There was, however, a significant group of cigar smokers, associated with higher parental education, who were not current cigarette smokers. CONCLUSIONS Use of alternative tobacco poses a risk to the success of tobacco control efforts. While many alternative tobacco users smoke cigarettes, some alternative tobacco users are current cigarette smokers. Cigar use thus constitutes a potential serious risk for youth who otherwise might not be exposed to tobacco.
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Affiliation(s)
- Stephen Soldz
- Social Science Research and Evaluation, Inc., Brookline, MA 02446, USA.
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Abstract
The past year has seen some notable publications in the field of vasculitis epidemiology. The appearance of reports from several different parts of the world has permitted comparisons to be made. In Europe, Wegener granulomatosis appears to be more common at high latitudes, whereas microscopic polyangiitis shows the reverse pattern. Kawasaki disease is most common in Japan. In China, the United States, and the United Kingdom, the incidence is lower, but the incidence appears to be increasing globally. Studies of infectious triggers continue to be disappointingly negative. Immunogenetic associations with cytokine polymorphisms are beginning to be reported.
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Affiliation(s)
- Richard A Watts
- Department of Rheumatology, Ipswich Hospital, NHS Trust, Ipswich, UK
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